'The Third International Consensus Definitions for Sepsis and Septic Shock' (Sepsis-3) 2015, released a validated screening tool for sepsis called the quick Sequential Organ Failure Assessment :(qSOFA) score (AUC 0.81), and consists of 3 simple criteria, where meeting two or more criteria is associated with poor outcomes due to sepsis:

• An alteration in mental status

• A decrease in systolic blood pressure < 100 mm Hg

• A respiration rate > 22 breaths/min

We aim to discover whether a recently developed, 'qSOFA' has a high predictive power (i.e. sensitivity and specificity), to identify those with serious infection (sepsis), from patients with a simple inflammatory response to infection. Once we have identified which tool works better in our population, we aim to trial the implementation of a 'Rapid Sepsis Response' pathway in the assessment area. This is vital because each hour delay to antibiotics results in a 7% mortality increase, and our current time to antibiotics in the assessment area is over 2 hours. Recent Emergency Department data has led us to question the effectiveness of our current sepsis algorithm based on 6 SIRs criteria, in a low acuity area. Our current screening tool when applied in 'Acute Assessment', has a high specificity 95% (CI 88.5-98.7), but low sensitivity 57% (CI 34.0-78.1).This results in unnecessary attention, from our predominantly junior team, to patients with a low risk of mortality, and delays in care to those that have a higher mortality, unless antibiotics are started within 1 hour. We hope will provide the best pathway to timely treatment and improved outcomes. Results will provide foundation for phase II of our study, which proposes a new pathway that provides better diagnosis of sepsis patients from the Emergency Department.